Medical director jobs in Buffalo, NY

AP Executive Staffing is partnering with a respected healthcare organization in the Southtowns to hire a Practice Manager who will oversee daily operations and support high quality patient care. This role is ideal for a hands-on leader who thrives in a fast-paced medical environment, builds strong relationships with providers, and drives operational excellence. About the Role The Practice Manager will lead the day-to-day operations of the medical practice while supporting staff, providers, and patients. This individual will ensure efficient workflows, maintain regulatory compliance, and partner closely with the Director of Operations to align practice performance with organizational goals. Key Responsibilities Operational Leadership • Oversee daily practice operations including scheduling, billing and administrative workflows • Monitor performance metrics and implement process improvements • Maintain policies and ensure compliance with healthcare standards Team Management • Supervise, mentor and develop administrative and clinical staff • Coordinate staffing schedules and lead regular team meetings • Support recruitment, onboarding and retention initiatives Provider Collaboration • Build strong working relationships with physicians and APPs • Resolve operational issues to support smooth clinical workflows • Serve as a communication link between providers and administrative teams Financial Oversight • Assist in budget management and financial planning • Ensure accurate and timely billing and revenue cycle processes • Track KPIs to evaluate operational and financial performance Patient Experience • Promote a positive and professional environment for patients and families • Address concerns and escalate issues when needed • Support quality and process improvement initiatives Regulatory Compliance • Ensure adherence to HIPAA, OSHA and all regulatory standards • Conduct audits and coordinate staff training on best practices Qualifications • Associate degree required; Bachelor's degree preferred • Minimum 5 years of experience in healthcare operations, practice management or office management • Strong leadership skills and experience guiding both administrative and clinical teams • Proficiency with EMR systems and practice management software • Strong financial acumen and experience with budgeting and revenue cycle processes • Excellent communication, problem-solving and organizational skills Why This Opportunity • Highly visible leadership role within a respected healthcare network • Opportunity to shape practice operations and support patient-centered care • Collaborative environment with strong support from senior leadership If you are a motivated healthcare operations professional who enjoys leading teams and improving practice performance, we would love to connect. Please apply or reach out to AP Executive Staffing for confidential consideration.

A rural community health center's Family Medicine Medical Director is retiring after a rewarding career in rural medicine for 35 years. As his vision to grow the health system comes to fruition his goal is to acclimate and mentor the new Medical Director for success. This community is located 40 minutes from an international airport and boasts a 18.9% lower cost of living than the US average. This is a leadership, Medical Director position. It can be all administrative or direct patient care and leadership. If you are passionate about primary care, and are looking for a rewarding opportunity to make a difference in a rural community, we encourage you to apply for this position. Qualifications MD/DO, Family Medicine or Primary Care Ability to gain an unrestricted license to practice in New York. 3-5 years of experience in primary care preferred. Strong clinical skills and knowledge of current medical practices. Excellent communication skills and ability to build rapport with patients and their families. Commitment to providing compassionate and patient-centered care. Ability to work independently and as part of a team in a fast-paced environment. Demonstrated commitment to community involvement and engagement. You will be working in a highly respected organization that is committed to quality patient care, maintaining realistic staffing levels that offer downtime during the day. You will not be overworked! Competitive wages, with superior pension and retirement plans with employer contributions. An excellent vacation, holiday and sick leave package. 40 hour week offering flexible schedule and hybrid remote Closed on Sundays & Holidays Relocation or sign on bonus Available!

JOB DESCRIPTION Job SummaryLeads and manages a team of medical directors delivering oversight and expertise in appropriateness and medical necessity of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Leads a team of medical directors responsible for assessing appropriateness and medical necessity of health care services provided to plan members. - Provides leadership and expertise in performance of prior authorization, inpatient concurrent review, discharge planning, care management and interdisciplinary care team (ICT) activities. - Recruits, hires, trains, mentors and develops medical director staff as needed. - Ensures that authorization decisions are rendered by qualified medical personnel and without hindrance due to fiscal or administrative incentives. - Analyzes data and identifies medical cost-savings and quality improvement opportunities. - Accounts for regulatory and accreditation performance of assigned team and responds to inquiries, issues and complaints from government and accreditation regulators. - Develops medical policies and procedures as needed. - Conducts peer review processes. Required Qualifications - At least 8 years of relevant experience, including clinical practice experience, and at least 2 years as a medical director in managed care setting supporting utilization management/quality management initiatives, or equivalent combination of relevant education and experience. - At least 3 years management/leadership experience. - Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice. - Board Certification. - Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. - Demonstrated ability to make strategic decisions. - Knowledge of health care regulatory and legislative processes, including ability to read and interpret legislation. - Experience gaining consensus, and collaborating in a highly matrixed organization. - Experience demonstrating strong leadership, communication, consensus building, collaboration and financial acumen abilities. - Evidence-based clinical criteria competency. - Peer review, medical policy/procedure development, and provider contracting experience. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other Health care or management certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $214,132 - $417,557 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

This position assists the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. This role supports the HARP line of business. Essential Accountabilities: Level I Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for capitated providers. Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Oversees the activities of physician advisors. Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies. Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment. Develops alliances with the provider community through the development and implementation of the medical management programs. May represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues, as needed. Represents the business unit at appropriate state committees and other ad hoc committees Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values and adhering to the Corporate Code of Conduct. Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) Reviews medical literature and applies evidence-based principles using high proficiency skills for a broad range of clinical services. Reviews internal trend reports to assess present and future needs and opportunities. Interacts with regulatory and accreditation agencies as assigned. Provides clinical support to the Sales and Marketing divisions Provides clinical leadership for the implementation of new utilization/case/quality management initiatives Minimum Qualifications: Level I New York State licensed physician. Minimum 7 years of experience in a BH managed care settings or BH clinical setting (at least 2 of which are in a clinical setting). This experience begins at the conclusion of any residency and/or fellowship training. Board certification in general psychiatry or certification in addiction medicine or certification in the subspecialty of addiction psychiatry. Appropriate training and expertise in general psychiatry and/or addiction disorders. Ability to identify, analyze and resolve complex medical issues. Skills in evidence-based medicine. Strong interpersonal skills essential for communication to staff at all levels of the organization., Basic skill sets in electronic communication systems such as e-mail and Word. Level II (in addition to Level I Minimum Qualifications) Superior evidence-based medicine skill set Strong interpersonal skills essential for communication to physicians in the community. Strong verbal presentation skills to lead internal and external discussions at board levels Advanced skill sets in electronic communication systems such as e-mail, Word, PowerPoint, and Excel. Physical Requirements: Ability to work prolonged periods sitting at a workstation and working on a computer. Ability to work while sitting and/or standing while at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time. Typical office environment including fluorescent lighting. Ability to work in a home office for continuous periods of time for business continuity. Ability to travel across the Health Plan service region for meetings and/or trainings as needed. Ability to lift, carry, push or pull 15 pounds or less. Manual dexterity including fine finger motion required. Repetitive motion required. The ability to hear, understand and speak clearly while using a phone, with or without a headset. ************ One Mission. One Vision. One I.D.E.A. One you. Together we can create a better I.D.E.A. for our communities. At the Lifetime Healthcare Companies, we're on a mission to make our communities healthier, and we can't do it without you. We know diversity helps fuel our mission and that's why we approach our work from an I.D.E.A. mindset (Inclusion, Diversity, Equity, and Access). By activating our employees' experiences, skills, and perspectives, we take action toward greater health equity. We aspire to reflect the communities we live in and serve, and strongly encourage people of color, LGBTQ+ people, people with disabilities, veterans, and other underrepresented groups to apply. OUR COMPANY CULTURE: Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation, and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits. In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): Min: $202,000 - Max: $303,000 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: The opportunity for remote work may be possible for all jobs posted by the Univera Healthcare Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

This is a remote-hybrid role with extensive in-market traveling to JV partners. Our company is looking for a devoted, compassionate doctor (MD -or- DO) to support the role of a Regional Medical Director. You must enjoy working in a challenging start-up environment. As the Regional Medical Director, you will oversee all aspects of medical operations for our contributions in a joint venture provider group. You will be directly responsible for market-level medical management, quality improvement, and clinical regulatory programs. This role reports to the Regional Chief Medical Officer. Requirements: One of the following: Valid NY State Doctor of Osteopathic Medicine (DO) Valid NY State Medical Doctor (MD) 4-years of medical leadership experience Experience working in a startup Vaccinated against COVID-19 (preferred) Comfortable working in a startup environment, flexible as things may change over time. This is a remote-hybrid role with extensive in-market traveling to JV partners Compensation: Salary starting at $280,000 based on experience Performance bonus up to 10% Job Duties: Willingness to work in a startup with a groundbreaking team of professionals focused on making a major impact in healthcare. Driving JV partnerships, serving in a capacity that supports the needs of all stakeholders, including the patients, partners and our employees. Serve as the liaison between all parties, continually centered on a patient-centric approach that comes with collaboration and mutual understanding. Provide oversight of clinical programs around disease management, palliative care planning, quality, and utilization management. Represent us at all stakeholder meetings, serving as an advocate for patients, the JV partner, and the organization. Handle all escalated clinical issues including, UM, appeals, grievances, and care management. Ensure continued adherence to all compliance and regulatory requirements Continually search available data to identify market-level opportunities for improved KPIs. Work cross-functionally with other markets, corporate operations, and partnered Portfolio companies to set strategy and prioritization for business growth. Develop local market relationships that demonstrate the high-value partnership with Honest can bring to a provider practice. Benefits: 10% Performance Bonus Full Benefits (Medical, Dental, & Vision) Competitive Base Pay + Bonuses PTO, 11 Paid Holidays 401K with match (coming soon) Reimbursement for continuing Medical Education Flexible work arrangements

Part-time Description Professional Care Medical Practices PC ("Professional Care”) is a private, physician founded, nationally accredited correctional health care practice. Professional Care provides comprehensive medical & mental health care services in the state of New York. Correctional health care is a unique, challenging, and exciting opportunity for today's medical professional in that it provides the ability to truly utilize all of your learned medical skills and knowledge on a daily basis. It is the perfect hybrid of Primary Care, Urgent Care, Emergency Medicine, and Addiction Medicine; providing care to an under-served, diverse, and appreciative patient population. We are currently looking for a Part Time - Physician / Medical Director to join our team and provide on-site medical care at the Genesee County Jail in Batavia, NY and Orleans County Jail in Albion, NY. This is a flexible Part-Time position, 16 - 20 hours of on-site care per week. Monday - Friday normal business hours To quickly summary some key points: Salaries are negotiable and commensurate based on experience; rate range is $130 - $170 per hour. Company-paid liability insurance (including tail) included; PTO /Sick Package for Part Time employees provided; Particle licensure reimbursement offered, and more. Requirements Graduate of an accredited School of Medicine or Osteopathic Medicine, specialty training preferred in Family Medicine, Internal Medicine, Emergency Medicine, Correctional Medicine, and/or Urgent Care. Licensed to practice Medicine in the State of New York. Board Certified or Board Eligible. Maintain current DEA number and eligible to prescribe medications in New York state. Maintain active BLS (i.e., CPR) certification. Maintain current Driver's License. Salary Description 130.00 - 170.00 per hour

Professional Care Medical Practices PC ("Professional Care”) is a private, physician founded, nationally accredited correctional health care practice. Professional Care provides comprehensive medical & mental health care services in the state of New York. Correctional health care is a unique, challenging, and exciting opportunity for today's medical professional in that it provides the ability to truly utilize all of your learned medical skills and knowledge on a daily basis. It is the perfect hybrid of Primary Care, Urgent Care, Emergency Medicine, and Addiction Medicine; providing care to an under-served, diverse, and appreciative patient population. We are currently looking for a Part Time - Physician / Medical Director to join our team and provide on-site medical care at the Genesee County Jail in Batavia, NY and Orleans County Jail in Albion, NY. This is a flexible Part-Time position, 16 - 20 hours of on-site care per week. Monday - Friday normal business hours To quickly summary some key points: Salaries are negotiable and commensurate based on experience; rate range is $130 - $170 per hour. Company-paid liability insurance (including tail) included; PTO /Sick Package for Part Time employees provided; Particle licensure reimbursement offered, and more. Requirements Graduate of an accredited School of Medicine or Osteopathic Medicine, specialty training preferred in Family Medicine, Internal Medicine, Emergency Medicine, Correctional Medicine, and/or Urgent Care. Licensed to practice Medicine in the State of New York. Board Certified or Board Eligible. Maintain current DEA number and eligible to prescribe medications in New York state. Maintain active BLS (i.e., CPR) certification. Maintain current Driver's License. Salary Description 130.00 - 170.00 per hour

Jericho Road Community Health Center is actively seeking a Site Medical Director (Physician). This position is full-time, within the Medical Care Department, working, primarily, at our 184 Barton location. Work with a Purpose Jericho Road Community Health Center offers the opportunity to be engaged in a movement far larger than any one individual. We believe that we can all be people of positive influence. We influence each other, our clients and patients, our families and communities. We are part of a global team that influences the health and wellbeing of communities internationally. Every day, Jericho Road's mission of caring for communities and advocating for systemic health equity guides us in our collective purpose. We are looking for individuals who share that goal and are committed to that service. As a federally qualified health center (FQHC), our organization's mission is deeply rooted in making fundamental change in the communities we serve, advocating for social justice and meeting people where they are. With global clinics across the world, the impact you make will transcend borders, with opportunities to engage in meaningful work at our Sierra Leone, Goma or Nepal global clinics. Why Jericho: Jericho Road offers competitive pay and benefits including medical (single-high coverage paid in full by employer), HSA, dental, vision, employer paid life insurance benefit, supplemental insurances, tuition discounts, generous paid time off, the opportunity for global travel to our three global health clinics, and loan forgiveness for applicable positions. Jericho Road values both work and life. The option for a flexible 40-hour workweek is possible within certain teams. Responsibilities: * Improve patient outcomes and deliver quality care within practice areas as assigned. * Provide high quality primary care for adult, pediatric, and basic gynecology patients of Jericho Road Community Health Center * Follow up with patients regarding lab results or other medical care concerns * Offer patient and family centered care * Ensure consistent, cost-effective care * Ensure all clinical care is delivered in a manner that meets or exceeds goals and expectations for clinical outcomes, quality assurance standards, state/local regulations, and patient satisfaction. * Participate in inpatient service OR participate in office call pool and work one Saturday morning per month * Provide patient care in a wholistic manner including attention to physical, mental, emotional, and spiritual health care * Collaborate with interdisciplinary clinical and program teams at Jericho Road Community Health Center * Supervision of medical providers at the Barton clinical site in collaboration with Chief Medical Officer * Clinical oversight of care provided at the Barton clinic * Facilitate clinical process improvements at our Barton clinical site related to patient access, population-based quality improvement, and patient experience * Work collaboratively with other site Medical Directors and Chief Medical Officer to improve provider satisfaction and joy in work * Be an example of servant leadership * Create a learning plan that includes familiarity with new research and changes to standard of practice * Participate in quality improvement activities with a data-driven approach * Attend required staff and provider meetings except when clinical activities prevent such attendance * Collaborate with interdisciplinary clinical and program teams at Jericho Road Community Health Center * Ensure all actions, personal conduct, and communications represent the organization in a highly professional manner at all times. * Uphold and ensure compliance to all policies/procedures, mission, and organizational values in a highly professional manner always. Maintain electronic medical records efficiently and maximize resources * Maintains current certifications including all mandatory annual and CPR training Qualifications: * Doctor of Medicine or Doctor of Osteopathy, licensed to practice in New York State prior to start date of employment * Previous leadership experience with a medical provider team desired * Previous medical director experience a plus * Completion of ACGME accredited residency training * Board-certified * Demonstrated ability to develop collaborative working relationships * Excellent patient-centered skills and clinical capabilities * Desired: Provide inpatient adult, pediatric, and obstetric care as part of a call pool with other physicians * Desired: Willingness to work with family medicine and pediatric residents Salary: $190,000-$200,000. Individual compensation is based on various factors unique to each candidate, including skill set, experience, qualifications, and other position related components. Job postings are not intended to be an exhaustive list of duties. You will be expected to perform different tasks as necessitated or required by your role within the organization and the overall missional objectives of the organization. Jericho Road is an Equal Opportunity Employer. We are an inclusive organization and actively promote equity of opportunity for all.

At Counterpart Health, we are transforming healthcare and improving patient care with our innovative tool, Counterpart Assistant. By supporting Primary Care Physicians (PCPs), we are able to deliver improved outcomes to our patients at a lower cost through early diagnosis and longitudinal care management of chronic conditions. We're hiring a Medical Director for the Gulf Region to own clinical relationships and outcomes across the region. You'll partner with the Head of the Gulf Region and Account Management leadership to ensure clinical quality, provider engagement, and market success. In this highly visible role, you'll be the clinical face of Counterpart Assistant to physician users-translating real‑world workflows into a great provider experience and closing the loop with our product teams. As a Medical Director, you will: Be the clinical relationship lead for the region: Build trusted relationships with physicians and practice leaders; understand local practice patterns and constraints; advocate for a seamless, high‑quality provider user experience. Drive clinical quality & provider engagement: Work side‑by‑side with the Head of Market and Account Management to set engagement plans, remove adoption friction, and deliver on clinical goals. Map workflows and integrate the product: Assess end‑to‑end outpatient workflows and recommend integration approaches that fit each practice, ensuring Counterpart Assistant complements existing processes. Educate and enable: Provide ongoing provider education on the Counterpart Assistant platform (trainings, office hours, virtual/in‑person sessions) and share best practices for clinical impact. Capture and channel feedback: Systematically collect provider feedback, usage insights, and clinical needs; synthesize into clear requirements and partner with Product/Design/Engineering to iterate and improve. Close the loop: Communicate product changes and feature roadmaps back to providers; highlight wins and measurable impact to stakeholders. Support implementations and expansions: Serve as the clinical lead during go‑lives and scale‑ups; ensure readiness, change management, and smooth onboarding for new providers. Success in this role looks like: Rising provider adoption and satisfaction (e.g., activation, weekly active use, training completion, NPS). Demonstrable clinical impact in the region (e.g., earlier condition identification, gap closure, documentation efficiency). Strong, collaborative execution with the Head of Market and Account Management; clear, data‑driven reporting on progress and risks. You should get in touch if: You have MD, DO, or NP with 5+ years of relevant clinical practice experience and 5+ years Medical Affairs experience; board‑certified/specialized in Internal Medicine, Family Medicine, Geriatrics, or related field. You have experience in medical affairs, provider engagement, or customer‑facing clinical roles within health technology or care delivery. You have a deep understanding of outpatient primary care workflows and value‑based care. You demonstrated ability to translate clinical workflows and provider feedback into product requirements and measurable outcomes. You have exceptional relationship‑building, communication, and stakeholder management skills with physicians and physician extenders. You are based in Alabama. Must be willing to travel locally within the state and Gulf Region up to 75% of the time. Bonus points if: You have a track record of leading regional clinical programs or market‑level initiatives. You have experience launching or scaling clinical software in ambulatory settings. You are comfortable interpreting analytics dashboards and turning insights into action. Benefits Overview: Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions. Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare. Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location. Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews. Additional Perks: Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities Reimbursement for office setup expenses Monthly cell phone & internet stipend Remote-first culture, enabling collaboration with global teams Paid parental leave for all new parents And much more! About Counterpart Health: In 2018, Clover Health set out to do something unprecedented: build a clinically intuitive, AI-enabled solution that fits within physicians' workflows to help support the earlier diagnosis and management of chronic conditions. Years later, that vision is a reality, with thousands of practitioners using Counterpart Assistant during patient visits to improve disease management, reduce medical expenses, and drive success in value-based care. With an exceptional team of value-based care and technology experts, Counterpart Health is driving value-based care at the speed of software. Counterpart Health is a subsidiary of Clover Health. From Clover's inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one's identity. All of our employee's points of view are key to our success, and inclusion is everyone's responsibility. #LI-REMOTE Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company. A reasonable estimate of the base salary range for this role is $260,000 to $310,000. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant's education, work experience, certifications, etc.

Job DescriptionDent Neurologic Institute is committed to excellence in all we do. Our culture is built on 4 key pillars: respect, quality, productivity, and well-being. By remaining dedicated to these values and the overall mission, we are dedicated to making a difference for both patients and colleagues. When you join the Dent team, you can take advantage of a variety of benefits: Work-Life Balance (no overnight shifts) Medical, Dental & Vision Plans Life Insurance 401(k) Retirement Plan Critical Illness, Accident, & Legal Plans Wellness Program Learning & Development Opportunities Paid Time Off Paid Holidays Free Onsite Parking at All Locations Schedule: Monday-Friday, 8:00am - 4:30pm Location: Headache/Neuro-oncology Center - Amherst Responsibilities of Position: Functions in knowledgeable manner in duties related to patient care Complies with quality assurance, HIPPA, customer focus, infection control, safety and other policies set forth. Responds appropriately to patient inquiries, providing accurate and detailed information along with referring physician's office inquiries. Answers all calls pertinent to assigned area, directing clinical calls to appropriate clinical personnel Works with patient and other office personnel to coordinate care Assures that patient films are accounted for and are returned to the patient, the file room, referring physician or radiology department from which they are received Makes follow-up phone calls to patients as provider directs Review and approve dictations from the providers and fax accordingly to referring physicians Obtain prior authorization for diagnostic testing and procedures Data entry into EMR pertaining to the patient's office visit; entering any prescriptions, diagnostic testing and outside procedures. Schedules follow up appointments for office visits and diagnostic testing that is to be done internally as well as externally Skills & Experience Necessary: General office skills, including typing skills. Strong planning, problem solving, organizational and interpersonal skills. Working knowledge of general office equipment including fax and copy machines, multi-line phone system, and personal computers Working proficiency with Microsoft Excel and Word programs. Ability to address and resolve conflict in a professional manner. Ability to maintain strict confidentiality. Ability to be flexible Required Education Associates Degree and 2 years related experience; or High School Diploma/GED and 3+ years related experience in a clinical setting. Medical secretary experience required Administrative experience reporting to CMO/C-Suite preferred Strong Microsoft office skills required Compensation: Most candidates will start within the first quartile of the pay range Rates are commensurate with experience EEO Statement Dent Neurologic Institute offers an inclusive work environment built on kindness and respect for all. Dent provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws as the basis for an employment decision. All qualified individuals are encouraged to apply and will receive consideration. Monday- Friday 8:00am - 4:30pm 40 hours/week

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is a remote based (work at home) based anywhere in the US. Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The Medical Director (Spine) will be a Subject Matter Expert (SME) with a background in Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically. Expands Aetna's medical management programs to address member needs across the continuum of care. Supports the Medical Management staff ensuring timely and consistent responses to members and providers. Leads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities. Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams. Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise, using multiple computer based applications. Required Qualifications* 2 or more years of experience in Health Care Delivery System e. g. , Clinical Practice and Health Care Industry. * Active and current state medical license without encumbrances. * M. D. or D. O. , Board Certification in a Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically. Preferred Qualifications* Previous healthcare insurance experience. Education* 2 or more years of experience in Health Care Delivery System e. g. , Clinical Practice and Health Care Industry. * Active and current state medical license without encumbrances. * M. D. or D. O. , Board Certification in a Orthopedic Spine OR Neurosurgery, including post-graduate direct patient care experience specifically. Neurosurgery, including post-graduate direct patient care experience specifically. Pay RangeThe typical pay range for this role is:$174,070. 00 - $374,920. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/30/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Veterinarian Medical Director (GP-lite, no surgery) West Side Pet Clinic, a sister clinic to North Buffalo Animal Hospital and Ellicott Street Animal Hospital, is seeking an experienced Veterinarian and Medical Director to lead our team. Pets should not go without care because of cost - and that belief is at the heart of everything we do. Founded in 2014 by Dr. Susan Sickels and Dr. R. Reed Stevens, West Side Pet Clinic was created to make high-quality veterinary medicine accessible for every family in Buffalo. By removing financial barriers, we help pets stay healthy and people keep the companions they love. We're looking for a doctor who shares this mission and prefers to focus exclusively on outpatient and preventive care without performing surgeries. The ideal candidate is a strong leader who combines compassion with a proactive attitude. They should be a team player who respects others, remains open-minded, and can stay composed under pressure. What to Expect Salary: $120,000 - $135,000 per year + 20% pro-sal Sign-On Bonus: $20,000 Location: 1255 Niagara St, Buffalo, NY 14213 Schedule: Open to full-time or part-time, flexible options available. The schedule is currently Monday through Friday, but we plan to open on Saturdays in the future, with participation required on a rotating basis. Hours of operation: Monday through Friday: 8am - 5pm Saturday: Currently closed, but we plan to open on Saturdays in the future, with participation required on a rotating basis. Sunday: Closed As you join our mission to provide accessible veterinary care to all pet owners, regardless of their financial situation, expect to be supported in your work and personal life with: A schedule that respects your time. You'll be scheduled for flexible shifts that meet your needs for work/life balance. No on-call duties, weekends, or holiday work are required! A 3:1 staff to doctor ratio. You will have the support-and respect-you need to be excellent for our patients. We've got your back. Our current team consists of 5 DVMs and a wonderful support staff of technicians, assistants, and CSRs. All the benefits you deserve-health, dental, vision, retirement-plus: sign-on bonus, relocation assistance, pet discounts, uniform allowance, CE allowance, and Employee Assistance Program (EAP), plus we will cover your dues, license fees and AVMA-PLIT! Paid time off. Catch your breath with Paid Time Off (PTO), paid holidays, and paid CE days every year. Take the time you need to recharge. Partnership opportunities through Veterinary Practice Partners (VPP), where more than 125 veterinarians co-own practices across 138 locations. VPP offers unmatched support in operations, marketing, and finance, allowing you to focus on your passion for veterinary medicine. Medical Director Responsibilities Ensure high standards of care and oversee patient treatment. Manage and mentor veterinary staff and conduct performance evaluations. Develop and implement medical protocols and quality control measures. Communicate with clients and manage the department's budget. Collaborate with other departments and stay updated on veterinary advancements. Lead emergency responses and engage with the community. About West Side Pet Clinic As Western New York's first low-cost animal clinic, we've halved vet bills compared to most. Our services include comprehensive physical exams, vaccinations, preventative medications, and treatment for common ailments. Your furry friend's well-being is our priority, providing quality care without breaking the bank. We provide quality, low-cost pet wellness care to the dogs and cats of Buffalo, Erie County, and Western New York. Pet wellness care includes routine exams, vaccinations, and screenings to detect any potential health issues early on. Our Story: Established in 2014, we offer a unique approach to high-quality, affordable pet wellness care. Our founders, veterinarians Susan Sickels, DVM, and R. Reed Stevens, DVM identified unmet needs for dogs and cats within the community, inspiring the creation of our clinic. Areas of Care: Complete physical exams Vaccinations Common health concerns (fleas, ticks, ear infections, allergies, worms, etc.) Educating pet owners on how preventing disease is less expensive than curing them Pets that require more advanced care such as X-rays, surgery or hospitalization are referred to one of our sister hospitals: Ellicott Street Animal Hospital and North Buffalo Animal Hospital Our Values: Compassion, affordability, and excellence are at the heart of everything we do. Our Mission & Goals: Our mission is to provide accessible veterinary care to all pet owners, regardless of their financial situation. We strive to ensure that every animal receives the professional attention and treatment they deserve, promoting their health and happiness. Our goal is to make quality veterinary services affordable and available to everyone, fostering a community where pets thrive and families are supported. AAHA-Accredited: As an AAHA-accredited practice, we meet the highest standards of veterinary care, ensuring pets receive top-notch service in a safe environment. Veterinary Services: Wellness Exams: Thorough check-ups to maintain health and provide necessary vaccinations. Diagnostic Services: In-house lab for screenings (heartworm, parasites, allergies, etc.). Nutritional Counseling: Personalized guidance on pet nutrition. Behavioral Counseling: Support for addressing behavioral issues. Client Education: Promoting the value of disease prevention. Puppy, Kitten, and Senior Care: Specialized services tailored to each life stage. Wondering what it's like to be part of the West Side Pet Clinic team? Check out our short video to hear from our doctors and staff about why they love coming to work each day and how we make a difference together - West Side Pet Clinic Requirements: State Veterinary Board License must be in good standing for the state in which they intend to be hired, prior to their start date. Flexible work schedule, with availability to work some weekends and holidays (as necessary, per hospital) DVM or VMD level degree required We are dedicated to establishing a culture that celebrates all forms of diversity and allows us to be an inclusive service provider in this community. #LI-JM2

STGi is currently seeking a Medical Director to provide services at our Community Based Outpatient Clinic. The general duty of the Medical Director is to provide oversight for the CBOC and comprehensive professional outpatient primary medical services to enrolled patients of the Veterans Affairs Medical Center (VAMC). This care will be delivered in accordance with the terms and conditions of the Veteran Affairs Primary Care Program. The Medical Director will also collaborate with the CBOC Clinic Manager to supervise the CBOC's day-to-day delivery of medical care. The Medical Director has the responsibility for overall supervision of all providers assigned. He/she will ensure continuous effective operations of the CBOC and participate in the Clinical Quality Assurance Program. ESSENTIAL FUNCTIONS: • Provide vision and direction of clinical services including new or improved program implementation • Provide medical care based on primary and preventive care to meet the needs (physical, mental, and emotional) of patients. • Coordinate and participate in the recruitment, and orientation of clinical staff physicians, physician assistants and nurse practitioners. • Collaborate with the CBOC Clinic Manager to provide leadership to CBOC clinicians. • Assist the STGi Program Manager in implementation of Quality Performance Improvement Team (QPIT) strategic initiatives. • Evaluate adherence to policies, procedures, and regulations to ensure compliance and patient safety. • Design and participate in quality improvement, care management, risk management, peer review, utilization review, clinical outcomes, and health enhancement activities. • Ensure consistency in evidence-based practice standards across the CBOC's. • Implement and attend provider huddles to assure situational awareness of clinic operational limitations and daily work planning. • Function as a director for the CLIA waived laboratory testing. • Expand clinical services by implementing and facilitating non-traditional encounters. • Analyze data to meet Veteran Administration (VA) clinical performance standards. • Participate on the STGi Performance Excellence Team (PET). • Establish a collaborative practice agreement with clinic APRN/PA and provide oversight and mentorship to other providers. • Evaluate and maintain universal precautions and infection control practices. • Administer medications per facility protocols. • Keep the VISTA clinic reminder tracking system and notifications current for each enrolled patient. • Comply with STGi policies and VA contract regulations. Required Skills REQUIRED EXPERIENCE AND SKILLS: • Retain an active, full and unrestricted medical license in New York. • Formal management and leadership courses and certifications are highly desired. • Experience in Internal Medicine or Family Practice • Board-certified by the ABMS in Internal Medicine or Family Practice or the BOS ABMS in Internal Medicine and or Family Practice or board eligible. • Current and unrestricted DEA. • Retain current Cardiopulmonary Resuscitation (CPR)/ Basic Life Support (BLS) from the American Heart Association (AHA) or the Military Training Network (MTN). • Knowledge of and ability to apply professional medical principles, procedures, and techniques in accordance with the community and VA standards of practice. • Knowledge of pharmacological agents used in patient treatment, including desired effects, side effects, complications, and patient usage considerations. • Demonstrate knowledge of age-specific customer service techniques with exceptional verbal, written, and telephone communication skills; adept at handling difficult situations with diplomacy and professionalism to ensure a positive customer experience. • Must be detailed oriented and have the ability to multi-task. • Experience with safe and reasonable practices regarding opioid medications for chronic pain. • Working knowledge of Microsoft Office Software and computer maneuverability including experience with electronic medical records systems.

Join a dynamic team as the Chief Medical Officer (CMO) at a leading urgent care group, with the search being conducted by HealthPlus Staffing! We are assisting this organization in finding an experienced and visionary leader to drive clinical excellence, enhance patient care, and foster collaboration across their growing network. Key Responsibilities: • Clinical Leadership: Guide the clinical vision and strategy for the organization. • Quality Assurance: Implement processes to ensure the highest standards of patient care. • Provider Support: Develop resources to enhance cost-effective, quality care delivery. • Compliance: Ensure adherence to clinical policies, regulations, and performance standards. • Collaboration: Build strong relationships with internal teams and external healthcare partners. • Staffing & Retention: Develop and execute recruitment, retention, and scheduling strategies. • Clinical Oversight: Dedicate 25% of time in clinical settings to observe and mentor medical teams. • Executive Involvement: Participate in high-level business and clinical strategy discussions. Qualifications: • Medical License: Unrestricted license in Connecticut, New York, and Massachusetts. • Board Certification: Family Medicine, Emergency Medicine, or Internal Medicine/Pediatrics. • Experience: Minimum of 5 years of post-residency patient care, with leadership in urgent care or emergency medicine. • Skills: Strong understanding of healthcare laws, electronic health records (EPIC preferred), and clinical risk management. Why Join This Team? • Lead a dedicated team focused on delivering high-quality patient care. • Be a key member of the executive management team, shaping the future of urgent care. • Drive quality improvement initiatives and mentor top-tier medical professionals. If you are ready to make a lasting impact in healthcare, apply now and become part of this mission-driven organization!

Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting improvements in efficiency and satisfaction for both members and providers and ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality member care - ensuring members receive the most appropriate care at the most effective setting. •Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-utilization. * Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management. * Assumes leadership relative to knowledge, implementation, training, and supervision of the use of the criteria for medical necessity. * Participates in and maintains the integrity of the appeals process, both internally and externally. * Responsible for investigation of adverse incidents and quality of care concerns. * Participates in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership and consultation for NCQA standards/guidelines for the plan including compliant clinical quality improvement activity (QIA) in collaboration with clinical leadership and quality improvement teams. * Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements. * Reviews quality referred issues, focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and other committees as directed by the chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review and manages the denial process. * Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality, cost-efficiency, and continuity of care. * Ensures that medical decisions are rendered by qualified medical personnel and not influenced by fiscal or administrative management considerations, and that care provided meets the standards for acceptable medical care. * Ensures medical protocols and rules of conduct for plan medical personnel are followed. * Develops and implements plan medical policies. * Provides implementation support for quality improvement activities. * Stabilizes, improves and educates primary care physicians and specialty networks; monitors practitioner practice patterns and recommends corrective actions as needed. * Fosters clinical practice guideline implementation and evidence-based medical practices. * Utilizes information technology and data analytics to produce tools to report, monitor and improve utilization management. * Actively participates in regulatory, professional and community activities. Required Qualifications * At least 3 years health care experience, including at least 2 years of medical practice experience, or equivalent combination of relevant education and experience. * Active and unrestricted Doctor of Medicine (MD) or Doctor of Osteopathy (DO) license in state of practice. * Board certification. * Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. * Ability to work cross-collaboratively within a highly matrixed organization. * Strong organizational and time-management skills. * Ability to multi-task and meet deadlines. * Attention to detail. * Critical-thinking and active listening skills. * Decision-making and problem-solving skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $161,914.25 - $315,733 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

SITE MEDICAL DIRECTOR (PHYSICIAN) Jericho Road Community Health Center is actively seeking a Site Medical Director (Physician). This position is full-time, within the Medical Care Department, working, primarily, at our 184 Barton location. Work with a Purpose Jericho Road Community Health Center offers the opportunity to be engaged in a movement far larger than any one individual. We believe that we can all be people of positive influence. We influence each other, our clients and patients, our families and communities. We are part of a global team that influences the health and wellbeing of communities internationally. Every day, Jericho Road's mission of caring for communities and advocating for systemic health equity guides us in our collective purpose. We are looking for individuals who share that goal and are committed to that service. As a federally qualified health center (FQHC), our organization's mission is deeply rooted in making fundamental change in the communities we serve, advocating for social justice and meeting people where they are. With global clinics across the world, the impact you make will transcend borders, with opportunities to engage in meaningful work at our Sierra Leone, Goma or Nepal global clinics. Why Jericho: Jericho Road offers competitive pay and benefits including medical (single-high coverage paid in full by employer), HSA, dental, vision, employer paid life insurance benefit, supplemental insurances, tuition discounts, generous paid time off, the opportunity for global travel to our three global health clinics, and loan forgiveness for applicable positions. Jericho Road values both work and life. The option for a flexible 40-hour workweek is possible within certain teams. Responsibilities: Improve patient outcomes and deliver quality care within practice areas as assigned. Provide high quality primary care for adult, pediatric, and basic gynecology patients of Jericho Road Community Health Center Follow up with patients regarding lab results or other medical care concerns Offer patient and family centered care Ensure consistent, cost-effective care Ensure all clinical care is delivered in a manner that meets or exceeds goals and expectations for clinical outcomes, quality assurance standards, state/local regulations, and patient satisfaction. Participate in inpatient service OR participate in office call pool and work one Saturday morning per month Provide patient care in a wholistic manner including attention to physical, mental, emotional, and spiritual health care Collaborate with interdisciplinary clinical and program teams at Jericho Road Community Health Center Supervision of medical providers at the Barton clinical site in collaboration with Chief Medical Officer Clinical oversight of care provided at the Barton clinic Facilitate clinical process improvements at our Barton clinical site related to patient access, population-based quality improvement, and patient experience Work collaboratively with other site Medical Directors and Chief Medical Officer to improve provider satisfaction and joy in work Be an example of servant leadership Create a learning plan that includes familiarity with new research and changes to standard of practice Participate in quality improvement activities with a data-driven approach Attend required staff and provider meetings except when clinical activities prevent such attendance Collaborate with interdisciplinary clinical and program teams at Jericho Road Community Health Center Ensure all actions, personal conduct, and communications represent the organization in a highly professional manner at all times. Uphold and ensure compliance to all policies/procedures, mission, and organizational values in a highly professional manner always. Maintain electronic medical records efficiently and maximize resources Maintains current certifications including all mandatory annual and CPR training Qualifications: Doctor of Medicine or Doctor of Osteopathy, licensed to practice in New York State prior to start date of employment Previous leadership experience with a medical provider team desired Previous medical director experience a plus Completion of ACGME accredited residency training Board-certified Demonstrated ability to develop collaborative working relationships Excellent patient-centered skills and clinical capabilities Desired: Provide inpatient adult, pediatric, and obstetric care as part of a call pool with other physicians Desired: Willingness to work with family medicine and pediatric residents Salary: $190,000-$200,000. Individual compensation is based on various factors unique to each candidate, including skill set, experience, qualifications, and other position related components. Job postings are not intended to be an exhaustive list of duties. You will be expected to perform different tasks as necessitated or required by your role within the organization and the overall missional objectives of the organization. Jericho Road is an Equal Opportunity Employer. We are an inclusive organization and actively promote equity of opportunity for all.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position SummaryAetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We believe that a better care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is a remote based (work at home) based anywhere in the US. Responsibilities of this Medical Director role are related to Medicare Appeals:* Direct daily work on part C appeals (both provider and member/nonparticipating providers). * Provide direct support to appeal nurses and dedicated Medicare part D pharmacists; supervision and participation in the Second Look Review (SLR) process* Provide direct support to the Quality Review nurses Provide after hours and weekend coverage on a rotational basis to support 24/7 appeals work* IRE monitoring and tracking and Utilization Management Strategy support* Develop subject matter expertise on Medicare policy for the enterprise* Provide ongoing education regarding Medicare policy and appeals to the appeal nurses and territory Utilization Management Staff* Participate in ongoing initiatives to improve appeals team efficiency and clinical consistency Required Qualifications:* Two (2) or more years of experience in a Health Care Delivery System e. g. , Clinical Practice or Health Care Industry * Medical License (MD) or (DO)* An Active state medical license without encumbrances* Board Certified in ABMS or AOA Recognized SpecialtyPreferred Qualifications* Medical Management - Medicare Complaints, Grievance & Appeals experience. * Health Plan Experience Highly PreferredEducation* Medical License (MD) or (DO) Pay RangeThe typical pay range for this role is:$174,070. 00 - $374,920. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 12/31/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Dent Neurologic Institute is committed to excellence in all we do. Our culture is built on 4 key pillars: respect, quality, productivity, and well-being. By remaining dedicated to these values and the overall mission, we are dedicated to making a difference for both patients and colleagues. When you join the Dent team, you can take advantage of a variety of benefits: * Work-Life Balance (no overnight shifts) * Medical, Dental & Vision Plans * Life Insurance * 401(k) Retirement Plan * Critical Illness, Accident, & Legal Plans * Wellness Program * Learning & Development Opportunities * Paid Time Off * Paid Holidays * Free Onsite Parking at All Locations Schedule: Monday-Friday, 8:00am - 4:30pm Location: Headache/Neuro-oncology Center - Amherst Responsibilities of Position: * Functions in knowledgeable manner in duties related to patient care * Complies with quality assurance, HIPPA, customer focus, infection control, safety and other policies set forth. * Responds appropriately to patient inquiries, providing accurate and detailed information along with referring physician's office inquiries. * Answers all calls pertinent to assigned area, directing clinical calls to appropriate clinical personnel * Works with patient and other office personnel to coordinate care * Assures that patient films are accounted for and are returned to the patient, the file room, referring physician or radiology department from which they are received * Makes follow-up phone calls to patients as provider directs * Review and approve dictations from the providers and fax accordingly to referring physicians * Obtain prior authorization for diagnostic testing and procedures * Data entry into EMR pertaining to the patient's office visit; entering any prescriptions, diagnostic testing and outside procedures. * Schedules follow up appointments for office visits and diagnostic testing that is to be done internally as well as externally Skills & Experience Necessary: * General office skills, including typing skills. * Strong planning, problem solving, organizational and interpersonal skills. * Working knowledge of general office equipment including fax and copy machines, multi-line phone system, and personal computers * Working proficiency with Microsoft Excel and Word programs. * Ability to address and resolve conflict in a professional manner. * Ability to maintain strict confidentiality. * Ability to be flexible Required Education * Associates Degree and 2 years related experience; or * High School Diploma/GED and 3+ years related experience in a clinical setting. * Medical secretary experience required * Administrative experience reporting to CMO/C-Suite preferred * Strong Microsoft office skills required Compensation: * Most candidates will start within the first quartile of the pay range * Rates are commensurate with experience EEO Statement Dent Neurologic Institute offers an inclusive work environment built on kindness and respect for all. Dent provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws as the basis for an employment decision. All qualified individuals are encouraged to apply and will receive consideration. Monday- Friday 8:00am - 4:30pm 40 hours/week

Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. Knowledge/Skills/Abilities Provides Psychiatric leadership for utilization management and case management programs for mental health and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management policies and procedures to improve quality outcomes and decrease costs. * Provide regional medical necessity reviews and cross coverage * Standardizes UM practices and quality and financial goals across all LOBs * Responds to BH-related RFP sections and review BH portions of state contracts * Assist the BH MD lead trainers in the development of enterprise-wide teaching on psychiatric diagnoses and treatment * Provides second level BH clinical reviews, BH peer reviews and appeals * Supports BH committees for quality compliance. * Implements clinical practice guidelines and medical necessity review criteria * Tracks all clinical programs for BH quality compliance with NCQA and CMS * Assists with the recruitment and orientation of new Psychiatric MDs * Ensures all BH programs and policies are in line with industry standards and best practices * Assists with new program implementation and supports the health plan in-source BH services * Additional duties as assigned Job Qualifications REQUIRED EDUCATION: * Doctorate Degree in Medicine (MD or DO) with Board Certification in Psychiatry REQUIRED EXPERIENCE: * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/Managed Care experience * Experience demonstrating strong management and communication skills, consensus building and collaborative ability, and financial acumen. * Knowledge of applicable state, federal and third-party regulations Required License, Certification, Association Active and unrestricted State (TX) Medical License, free of sanctions from Medicaid or Medicare. Preferred Experience * Peer Review, medical policy/procedure development, provider contracting experience. * Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease management, and evidence-based guidelines. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJHS #LI-AC1 Pay Range: $161,914.25 - $315,733 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.